ABSTRACT
BACKGROUND: Given the expansion of remote digital dermatology services from the National Health Service, particularly during the COVID-19 pandemic, there is a need for methods that identify patients at risk of digital exclusion to guide equitable representation in service co-design processes and tailor remote services to the needs of their patient population. OBJECTIVE: This quality improvement project aims to inform the redesign of remote services to optimally support the ongoing needs of patients with chronic skin diseases, ensuring that the services are tailored to patients' digital health literacy requirements. METHODS: We profiled the digital health literacy of 123 people with chronic skin conditions who require long-term surveillance in 2 specialist clinics (London, United Kingdom) using the Multidimensional Readiness and Enablement Index for Health Technology (READHY) questionnaire alongside the Optimizing Health Literacy and Access (Ophelia) process for hierarchical cluster analysis. RESULTS: The cluster analysis of READHY dimensions in responding participants (n=116) revealed 7 groups with distinct digital and health literacy characteristics. High READHY scores in groups 1 (n=22, 19%) and 2 (n=20, 17.2%) represent those who are confident with managing their health and using technology, whereas the lower-scoring groups, 6 (n=4, 3.4%) and 7 (n=12, 10.3%), depended on traditional services. Groups 3 (n=27, 23.3%), 4 (n=23, 19.8%), and 5 (n=8, 6.9%) had varying digital skills, access, and engagement, highlighting a population that may benefit from a co-designed dermatology service. CONCLUSIONS: By identifying patient groups with distinguishable patterns of digital access and health literacy, our method demonstrates that 63.8% (n=74) of people attending specialist clinics in our center require support in order to optimize remote follow-up or need an alternative approach. Future efforts should streamline the READHY question profile to improve its practicality and use focus groups to elicit strategies for engaging patients with digital services.
Subject(s)
Kidney Transplantation/adverse effects , Patient Safety/statistics & numerical data , Skin Diseases/diagnosis , Telemedicine/methods , Transplant Recipients/statistics & numerical data , Triage/methods , Dermatology/methods , Female , Humans , Kidney Transplantation/methods , Male , Organ Transplantation/adverse effects , Organ Transplantation/methods , Pilot Projects , Prospective Studies , Referral and Consultation , Remote Consultation/methods , Skin Diseases/etiology , Skin Diseases/therapy , United KingdomABSTRACT
A 12-year-old boy had lesions clinically and histopathologically consistent with lymphomatoid papulosis (LP) which were persistent and appeared grouped in a circumscribed area of normal looking background skin on the right abdomen. Staging work-up did not disclose systemic disease. Persistent agmination of lymphomatoid papulosis (PALP) is somewhat different from classical LP because it involves a circumscribed, patch-sized area of the skin and the papules within never resolve completely despite some waxing and waning. PALP might be considered a localized or regional form of LP or a distinct lymphoproliferative disorder; in any case, at least a cautious long-term follow up is recommended, with attention to the possible development of true lymphoma.
Subject(s)
Lymphomatoid Papulosis/pathology , Skin Neoplasms/pathology , Skin/pathology , Biopsy , Child , Humans , Ki-1 Antigen/metabolism , Lymphomatoid Papulosis/metabolism , Male , Skin/metabolism , Skin Neoplasms/metabolismSubject(s)
Dermatitis, Allergic Contact/etiology , Dermatologic Agents/adverse effects , Perfume/adverse effects , Terpenes/adverse effects , Acyclic Monoterpenes , Administration, Cutaneous , Dermatitis, Allergic Contact/diagnosis , Dermatologic Agents/administration & dosage , Humans , Male , Middle Aged , Patch Tests , Varicose Ulcer/drug therapyABSTRACT
Eosinophilic folliculitis is considered a heterogeneous group of disorders, with several clinical subsets, sharing a common histopathological appearance. Increasing numbers of cases, following bone marrow transplantation (BMT), have been reported in recent years. We herein present a case of eosinophilic folliculitis that appeared in a 26-year-old woman 5 months after allogeneic peripheral blood stem cell transplantation as treatment for eosinophilic acute leukemia. Our review of the published cases has shown that eosinophilic folliculitis in patients after BMT could be considered as a pattern of reaction related to immune dysregulation.
Subject(s)
Eosinophilia/etiology , Folliculitis/etiology , Peripheral Blood Stem Cell Transplantation/adverse effects , Adult , Anti-Inflammatory Agents/therapeutic use , Eosinophilia/drug therapy , Eosinophilia/pathology , Female , Folliculitis/drug therapy , Folliculitis/pathology , Humans , Leukemia, Eosinophilic, Acute/therapy , Prednisone/therapeutic use , Transplantation, Homologous , Treatment OutcomeSubject(s)
Anti-Inflammatory Agents/adverse effects , Dermatitis, Photoallergic/etiology , Ketoprofen/analogs & derivatives , Oils, Volatile/adverse effects , Plant Oils/adverse effects , Dermatitis, Photoallergic/diagnosis , Female , Humans , Ketoprofen/adverse effects , Lavandula , Middle Aged , Patch Tests/methods , Ultraviolet Rays/adverse effectsSubject(s)
Antibodies, Monoclonal/adverse effects , Antineoplastic Agents/adverse effects , Cytokines/metabolism , Lymphoma, B-Cell/drug therapy , Skin Neoplasms/drug therapy , Adult , Antibodies, Monoclonal, Murine-Derived , Cicatrix/pathology , Diagnosis, Differential , Humans , Male , Rituximab , SyndromeABSTRACT
No disponible
Subject(s)
Female , Middle Aged , Humans , Pemphigus/complications , Pemphigus/diagnosis , Pemphigus/drug therapy , Adrenal Cortex Hormones/therapeutic use , Azathioprine/therapeutic use , Autoimmune Diseases/complications , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents , Recurrence/prevention & control , Autoimmune Diseases/diagnosis , Dermatomycoses/drug therapy , Skin Diseases, Infectious/drug therapyABSTRACT
La queratodermia espinosa palmar es una entidad poco frecuente y de etiología desconocida. La mayor parte de los casos descritos son adquiridos, pero existen también casos familiares. Esta dermatosis se caracteriza por la aparición de proyecciones hiperqueratósicas milimétricas en palmas y/o plantas, por lo general asintomáticas. En el estudio histológico se observan columnas paraqueratósicas, a modo de laminillas cornoides, sobre una epidermis con una capa granulosa adelgazada o ausente. Se ha descrito su asociación con enfermedad tumoral maligna de diversos tipos. Presentamos un nuevo caso de esta entidad que tenía como peculiaridad la relación de la columna paraqueratósica con el acrosiringio en algunos cortes histológicos, hallazgo característico del nevo del conducto dérmico o del ostium ecrino poroqueratósico. Esta asociación se ha descrito de forma aislada con anterioridad
Spiny keratoderma of the palms is an infrequent entity of unknown etiology. Most of the cases described are acquired, but there are also family cases. This dermatosis is characterized by the appearance of hyperkeratotic, generally asymptomatic, projections on the palms and/or soles, measuring only a few millimeters. In the histological study, parakeratotic columns of cornoid lamellae were observed on an epidermis with a thin or absent granular layer. Its association with malignant tumor pathologies of different types has been described. We present a new case of this entity, which had the peculiarity of a relationship of the parakeratotic column with the acrosyringium in some histological sections, a finding typical of a porokeratotic eccrine ostial or dermal duct nevus
Subject(s)
Humans , Keratoderma, Palmoplantar/pathology , Hyperkeratosis, Epidermolytic/pathology , Parakeratosis/pathology , Nevus/pathology , Porokeratosis/pathologySubject(s)
Skin Diseases/pathology , Synovial Cyst/pathology , Adolescent , Adult , Female , Humans , Male , Middle AgedABSTRACT
Spiny keratoderma of the palms is an infrequent entity of unknown etiology. Most of the cases described are acquired, but there are also family cases. This dermatosis is characterized by the appearance of hyperkeratotic, generally asymptomatic, projections on the palms and/or soles, measuring only a few millimeters. In the histological study, parakeratotic columns of cornoid lamellae were observed on an epidermis with a thin or absent granular layer. Its association with malignant tumor pathologies of different types has been described. We present a new case of this entity, which had the peculiarity of a relationship of the parakeratotic column with the acrosyringium in some histological sections, a finding typical of a porokeratotic eccrine ostial or dermal duct nevus.
